Eloise is in her 40’s and was detained in a Mental Health Unit under section 3 of the Mental Health Act. 

Eloise is homeless and often lives on the streets when she is not in hospital. Eloise’s Consultant Psychiatrist describes her as having schizophrenia and an undiagnosed learning disability.

Eloise was prescribed a long-lasting anti-psychotic medication in the form of a ‘Depot injection’ to help with the symptoms of her schizophrenia as her mental health has become more stable during her hospital stay. Normally, she would be discharged from hospital at this point, but Eloise had a large lump on her neck which she has had for more than 5 years, and her consultant felt it necessary to investigate this further while she was in hospital. Eloise had previously failed to attend any hospital appointments made for her about the lump. 

Eloise was given a biopsy and was subsequently diagnosed with a rare form of cancer. 

As Eloise did not have any friends or family to consult with, and she was assessed as lacking the capacity to make decisions about her medical treatment, the law says that Eloise should have an Independent Mental Capacity Advocate (IMCA) to support her to make her views known about proposed treatments. Eloise was referred to POhWER for support from an IMCA to enable her to communicate her wishes more clearly so that professionals could make a best interest’s decision about Eloise’s treatment. 

Jonathan, a POhWER advocate, spoke with the referring doctor, and considering Eloise’s mental health and undiagnosed learning disability, suggested that some reasonable adjustments may be needed when she attended the outpatient’s appointment to discuss the lump. It was agreed that Jonathan attend the outpatient’s appointment with Eloise. 

At the appointment, Eloise was seen by an Ear, Nose and Throat (ENT) consultant who examined the lump. He used simple language to explain what the lump was and what needed to happen next. Jonathan supported Eloise to ask questions and understand the responses from the consultant. Due to Eloise’s age, and previous scans which showed the cancer had not spread, it was felt that it was in Eloise’s best interest have an operation and radiotherapy. Eloise then agreed with the treatment plan.

After the outpatient’s appointment, Jonathon wrote and submitted a Serious Medical Treatment report to the decision maker. The report made it clear that due to Eloise’s mental health they would need to make reasonable adjustments to support her before, during, and after the procedures. He made it clear that a familiar member of staff from the mental health unit should stay with her before and after her operation and that the whole nursing team on the surgical ward should be made aware of Eloise’s mental health and treatment so they would understand how best to support her. Jonathan also suggested they should ensure good communication with Eloise throughout her treatment including giving her easy read information about the procedures so that she could better understand what would happen. 

Eloise had the operation which went well, and the reasonable adjustments Jonathan had suggested were implemented. Eloise is currently undergoing radiotherapy which will complete the treatment.

Jonathan helped uphold Eloise’s healthcare right to getting information about her treatment, and ensured that this was in a format/language that she could understand. Eloise thanked Jonathan for all of his support and for making sure she understood what her doctors were telling her about her health and treatment.